Urinary Arsenic Species and CKD in a Taiwanese Population: A Case-Control Study
Urinary Arsenic Species and CKD in a Taiwanese Population: A Case-Control Study
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DOI：
10.1053/j.ajkd.2009.06.016
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发表时间：
2009-11-01
影响因子：
13.2
通讯作者：
Su, Chien-Tien
中科院分区：
文献类型：
--
作者：
Hsueh, Yu-Mei;Chung, Chi-Jung;Su, Chien-Tien
背景：无机砷通过氧化损伤与肾功能下降有关。砷的甲基化被认为是砷代谢的一个途径。番茄红素是一种抗氧化剂，可降低氧化应激;然而，尿砷种类、血浆番茄红素水平和慢性肾脏病（CKD）之间的关联很少被评估。研究设计：病例对照研究。设置和参与者：从医院库中招募125名CKD患者和229名对照。预测因子：尿砷种类和血浆番茄红素水平。结果和测量：CKD定义为估计肾小球滤过率（eGFR）低于60 mL/min/1.73 m2，采用肾脏疾病饮食改良研究公式计算。采用高效液相色谱法测定血浆番茄红素。结果：番茄红素水平与eGFR呈正相关，血清番茄红素水平高的参与者与CKD呈显著负相关（比值比，0.41; 95%置信区间，0.21至0.81）。总砷水平与CKD呈剂量反应关系，尤其是在总砷水平大于20.74 μ g/g肌酐或更低的参与者中（比值比，4.34; 95%置信区间，1.94至9.69）。此外，当参与者的血浆番茄红素水平低时，尿总砷水平高的参与者或二甲基胂酸百分比低的参与者与CKD呈正相关。局限性：由于血浆抗氧化剂和尿砷种类的单点评价和样本量小，统计学意义应谨慎解释。结论：本研究显示高尿总砷或低血浆番茄红素水平与CKD呈正相关。结果表明，砷甲基化的能力可能与慢性肾脏病的个人谁摄入低砷水平的饮用水，也有一个低血浆番茄红素水平。美国肾脏病杂志54：859-870。(C)2009年，美国国家肾脏基金会（National Kidney Foundation，Inc.）
Background: Inorganic arsenic has been linked to decreased kidney function through oxidative damage. Arsenic methylation is believed to be a pathway for arsenic metabolism. Lycopene is an antioxidant that reduces oxidative stress; however, the association between urinary arsenic species, plasma lycopene level, and chronic kidney disease (CKD) has seldom been evaluated.Study Design: Case-control study.Setting & Participants: 125 patients with CKD and 229 controls were recruited from a hospital-based pool.Predictor: Urinary arsenic species and plasma lycopene level.Outcomes & Measurements: CKD was defined as estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m(2), calculated by using the Modification of Diet in Renal Disease Study equation. Plasma lycopene was measured by means of high-performance liquid chromatography. Urinary arsenic species, including arsenite, arsenate, monomethylarsonic acid, and dimethylarsinic acid, were determined by means of high-performance liquid chromatography and hydride generator-atomic absorption spectrometry.Results: Lycopene level was associated positively with eGFR, and participants with a high serum lycopene level had a significant, inverse association with CKD (odds ratio, 0.41; 95% confidence interval, 0.21 to 0.81). Total arsenic level was associated significantly with CKD in a dose-response relationship, especially in participants with a total arsenic level greater than 20.74 compared with 11.78 mu g/g creatinine or less (odds ratio, 4.34; 95% confidence interval, 1.94 to 9.69). Furthermore, participants with a high urinary total arsenic level or participants with a low percentage of dimethylarsinic acid had a positive association with CKD when their plasma lycopene level was low.Limitations: Because of the single spot evaluation of plasma antioxidants and urinary arsenic species and the small sample size, statistical significance should be interpreted with caution.Conclusions: This study shows that high urinary total arsenic or low plasma lycopene level is associated positively with CKD. Results suggest that the capacity for arsenic methylation may be associated with CKD in individuals who ingest low arsenic levels in drinking water and also have a low plasma lycopene level. Am J Kidney Dis 54:859-870. (C) 2009 by the National Kidney Foundation, Inc.